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Transcript
AnatomicalDescrip0onofaScia0c
AncillaryBranch
totheGluteusMaximus
SalvadorCamposDorador,MD1;RicardoG.Schröder,PT1;
JuanGomez-Hoyos,MD1,3;AnthonyKhouryM.Sc.1,4;IanJ.
Palmer,PhD1;HalDMar0n,DO1.
1.  HipPreserva0onCenteratBaylorScoN&WhiteHealth
System,Dallas,Texas,EUA.
2.  UniversityofAn0oquia,Medellin,Colombia.
3.  DepartmentofBioengineering,UTArlington,Arlington,
Texas,EUA.
HalDMar0n–Educa0onalConsultantforSmith&Nephew
Background
•  Innerva0onoftheGluteusMaximusMuscle(GMM)issuppliedbytheInferior
GlutealNerve(IGN).
•  TheInferiorGlutealNerveleavesthepelvisviagreaterscia0cforamen,inferior
andanteriortothePiriformismuscleandlateraltotheScia0cNerve.
•  TheIGNthendividesintobranchesthatpassposteriorlyintothedeepsurface
oftheGluteusMaximusMuscle.
Background
•  Ancillaryneurologicbranchesinnerva0ng0ssuemayariseinagiven
popula0on.
•  Threecasereportsfromaroundtheglobehavereportedanancillary
branchfromSN.
•  AnancillarybranchfromtheSNtotheGMMobservedduringendoscopic
releaseoftheSNinthedeepglutealspacehasnotbeendescribed.
•  Theobjec0veofthisstudywastoexaminethepresenceofaScia0c
AncillaryBranchindependentfromIGNgoingtotheGMM.Thehypothesis
statesthatanancillarybranchfromtheSN,independentfromIGN,
extendsdirectlytotheGMMinthedeepglutealspace.
Methods
• 
• 
• 
Thirteenhipsfromsevenfreshfrozenhumancadavericpelviseswereanalyzed.
APosterolateralapproachwasu0lizedwiththeGMMreflectedfromlateralto
medialtoexposethedeepglutealspace.Thedeepglutealspacewasexaminedby
bluntdissec0ontoiden0fytheSNandpoten0alpresenceofanancillarybranch.
Adigitalcaliper(GagingInside,SanClemente,California,USA;0.01accuracy)was
usedforallmeasurements.Thefollowingfourmeasurementswererecordedby
thesameinves0gator:
(I)SNdiameteratthegreaterscia0cforamen
(II)Scia0cAncillaryBranchdiameterattheoriginoftheSN
(III)lengthfromthegreaterscia0cforamentothepointoforiginofScia0c
AncillaryBranchontheScia0cNerve,and
(IV)Scia0cAncillaryBranchlengthfromScia0cNervetotheini0alpointof
contacttotheGluteusMaximusMuscle.
Results
•  Fiveofthirteenhipsanalyzed(38%)showedthepresenceof
Scia0cAncillaryBranch.Twocadavers(4hips)showedaSAB
bilaterally.1hippresentedaunilateralSABiden0fiedinthe
righthip.
Conclusion
The SAB was observed in 38% of the analyzed
human cadaveric hips. The present findings
provide a beNer understanding of the
neurological varia0ons in the deep gluteal
space,whichhelptoguidetreatmentdecisions.
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